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1. A long-lasting porcine model of ARDS caused by pneumonia and ventilator-induced lung injury

Author

Enric Barbeta, Marta Arrieta, Ana Motos, Joaquim Bobi, Hua Yang, Minlan Yang, Giacomo Tanzella, Pierluigi Di Ginnatale, Stefano Nogas, Carmen Rosa Vargas, Roberto Cabrera, Denise Battaglini, Andrea Meli, Kasra Kiarostami, Nil Vázquez, Laia Fernández-Barat, Montserrat Rigol, Ricard Mellado-Artigas, Gerard Frigola, Marta Camprubí-Rimblas, Pau Ferrer, Daniel Martinez, Antonio Artigas, Carlos Ferrando, Miquel Ferrer, and Antoni Torres

Subjects
ARDS, Ventilator-induced lung injury, Porcine model, Pneumonia, Double hit, Injurious mechanical ventilation, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background Animal models of acute respiratory distress syndrome (ARDS) do not completely resemble human ARDS, struggling translational research. We aimed to characterize a porcine model of ARDS induced by pneumonia—the most common risk factor in humans—and analyze the additional effect of ventilator-induced lung injury (VILI). Methods Bronchoscopy-guided instillation of a multidrug-resistant Pseudomonas aeruginosa strain was performed in ten healthy pigs. In six animals (pneumonia-with-VILI group), pulmonary damage was further increased by VILI applied 3 h before instillation and until ARDS was diagnosed by PaO2/FiO2

Published
2023
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2. Determining the most accurate 16S rRNA hypervariable region for taxonomic identification from respiratory samples

Author

Ruben López-Aladid, Laia Fernández-Barat, Victoria Alcaraz-Serrano, Leticia Bueno-Freire, Nil Vázquez, Roque Pastor-Ibáñez, Andrea Palomeque, Patricia Oscanoa, and Antoni Torres

Subjects
Medicine, Science
Abstract

Abstract 16S rRNA gene profiling, which contains nine hypervariable regions (V1–V9), is the gold standard for identifying taxonomic units by high-throughput sequencing. Microbiome studies combine two or more region sequences (usually V3–V4) to increase the resolving power for identifying bacterial taxa. We compare the resolving powers of V1–V2, V3–V4, V5–V7, and V7–V9 to improve microbiome analyses in sputum samples from patients with chronic respiratory diseases. DNA were isolated from 33 human sputum samples, and libraries were created using a QIASeq screening panel intended for Illumina platforms (16S/ITS; Qiagen Hilden, Germany). The analysis included a mock community as a microbial standard control (ZymoBIOMICS). We used the Deblur algorithm to identify bacterial amplicon sequence variants (ASVs) at the genus level. Alpha diversity was significantly higher for V1–V2, V3–V4, and V5–V7 compared with V7–V9, and significant compositional dissimilarities in the V1–V2 and V7–V9 analyses versus the V3–V4 and V5–V7 analyses. A cladogram confirmed these compositional differences, with the latter two being very similar in composition. The combined hypervariable regions showed significant differences when discriminating between the relative abundances of bacterial genera. The area under the curve revealed that V1–V2 had the highest resolving power for accurately identifying respiratory bacterial taxa from sputum samples. Our study confirms that 16S rRNA hypervariable regions provide significant differences for taxonomic identification in sputum. Comparing the taxa of microbial community standard control with the taxa samples, V1–V2 combination exhibits the most sensitivity and specificity. Thus, while third generation full-length 16S rRNA sequencing platforms become more available, the V1–V2 hypervariable regions can be used for taxonomic identification in sputum.

Published
2023
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3. Bacterial Adaptive Memory in Methicillin-Resistant Staphylococcus aureus from Endotracheal Tubes

Author

Laia Fernández-Barat, Ruben López-Aladid, Nil Vázquez, Roberto Cabrera, Jordi Vila, Miquel Ferrer, and Antoni Torres

Subjects
methicillin-resistant Staphylococcus aureus, biofilm, endotracheal tubes, nosocomial pneumonia, ventilator-associated pneumonia, gene expression, Medicine
Abstract

Objectives: To evaluate the expression dynamics of biofilm genes in methicillin-resistant Staphylococcus aureus (MRSA) retrieved from endotracheal tubes (ETT) and to determine how gene regulation is attenuated in vitro where host–environmental factors are no longer present. Methods: Biofilm was grown (24 h) in tryptic broth soy plus 0.25% glucose for a clinical MRSA isolate in planktonic state and after sessile growth named ETT-MRSA (S2, S3, S4, S5, S6, S7). Gene expression of five biofilm-related genes (icaC, clfB, ebps, fnbB, and RNA III) was assessed consecutively from day 1 to day 4 after ETT growth through real-time PCR. 16S rRNA was used as a control. Results: The MRSA isolates retrieved from ETT were capable of producing biofilms dependent on ica. The gene expression dynamics of ETT-MRSA changed progressively compared to planktonic MRSA gene expression under both ambient air (p < 0.001) and ambient air with 5% CO2 (p < 0.001). Dynamic assessment of icaC expression in both atmospheric conditions showed progressive downregulation in vitro compared to in vivo ETT biofilms. The expression patterns of clfB and ebps genes were similar to icaC. In contrast, the expression of the RNA III gene showed progressive upregulation from day 1 to day 4 (p < 0.001). Conclusions: MRSA loses its biofilm gene expression in vitro, by adaptive features across multiple generations, as evidenced by the progressive downregulation of icaC and upregulation of RNA III. These findings underscore the significance of host–environment dependence in regulating bacterial biofilm genes, highlighting its importance in diagnostics. Bacterial strains lose their host-specific characteristics as they are cultured in vitro.

Published
2024
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4. The value of biofilm testing to guide antimicrobial stewardship in chronic respiratory diseases

Author

Laia Fernández-Barat, Nil Vázquez Burgos, Victoria Alcaraz, Leticia Bueno-Freire, Ruben López-Aladid, Roberto Cabrera, Albert Gabarrús, Andrea Palomeque, Patricia Oscanoa, Adrian Ceccato, Ana Motos, Rosanel Amaro, Thierry Bernardi, Christian Provot, Alba Soler-Comas, Laura Muñoz, Jordi Vila, and Antoni Torres

Subjects
Pseudomonas aeruginosa, antimicrobial agents, antimicrobial resistances, biofilm diagnose, biofilm, Microbiology, QR1-502
Abstract

IntroductionBiofilm production is an important yet currently overlooked aspect of diagnostic microbiology that has implications for antimicrobial stewardship. In this study, we aimed to validate and identify additional applications of the BioFilm Ring Test® (BRT) for Pseudomonas aeruginosa (PA) isolates from patients with bronchiectasis (BE).Materials and methodsSputa were collected from BE patients who had at least one PA positive culture in the previous year. We processed the sputa to isolate both mucoid and non-mucoid PA, and determined their susceptibility pattern, mucA gene status, and presence of ciprofloxacin mutations in QRDR genes. The Biofilm production index (BPI) was obtained at 5 and 24 hours. Biofilms were imaged using Gram staining.ResultsWe collected 69 PA isolates, including 33 mucoid and 36 non-mucoid. A BPI value below 14.75 at 5 hours predicted the mucoid PA phenotype with 64% sensitivity and 72% specificity.ConclusionOverall, our findings suggest that the fitness-cost associated with the mucoid phenotype or ciprofloxacin resistance is shown through a time-dependent BPI profile. The BRT has the potential to reveal biofilm features with clinical implications.

Published
2023
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5. Molecular characterization of methicillin-resistant Staphylococcus aureus clinical strains from the endotracheal tubes of patients with nosocomial pneumonia

Author

Roberto Cabrera, Laia Fernández-Barat, Anna Motos, Rubén López-Aladid, Nil Vázquez, Mauro Panigada, Francisco Álvarez-Lerma, Yuly López, Laura Muñoz, Pedro Castro, Jordi Vila, and Antoni Torres

Subjects
Endotracheal tube, Biofilm, Methicillin-resistant Staphylococcus aureus, Respiratory infection, Hospital-acquired pneumonia, Ventilator-associated pneumonia, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background Among all cases of nosocomial pneumonia, Staphylococcus aureus is the second most prevalent pathogen (17.8%). In Europe, 29.9% of the isolates are oxacillin-resistant. The changing epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) nosocomial infections and the decreasing susceptibility to first-line antibiotics leave clinicians with few therapeutic options. The objective of our study was to determine the antimicrobial susceptibility, the associated molecular mechanisms of resistance and the epidemiological relatedness of MRSA strains isolated from the endotracheal tubes (ETT) of intubated critically ill patients in the intensive care unit (ICU) with nosocomial pneumonia caused by Staphylococcus aureus. Methods The antimicrobial susceptibility to vancomycin, linezolid, ciprofloxacin, clindamycin, erythromycin, chloramphenicol, fusidic acid, gentamicin, quinupristin-dalfopristin, rifampicin, sulfamethoxazole/trimethoprim, and tetracycline were measured. Resistance mechanisms were then analyzed by polymerase chain reaction and sequencing. Molecular epidemiology was carried out by multi-locus sequence typing. Results S. aureus isolates were resistant to ciprofloxacin, erythromycin, gentamicin, tetracycline, clindamycin, and fusidic acid. The most frequent mutations in quinolone-resistant S. aureus strains were S84L in the gyrA gene, V511A in the gyrB gene, S144P in the grlA gene, and K401R/E in the grlB gene. Strains resistant to erythromycin carried the ermC, ermA, and msrA genes; the same ermC and ermA genes were detected in strains resistant to clindamycin. The aac(6′)-aph(2″) gene was related to gentamicin resistance, while resistance to tetracycline was related to tetK (efflux pump). The fusB gene was detected in the strain resistant to fusidic acid. The most frequent sequence types were ST22, ST8, and ST217, which were distributed in four clonal complexes (CC5, CC22, CC45, and CC59). Conclusions High levels of resistance to second-line antimicrobials threatens the treatment of nosocomial respiratory infections due to methicillin-resistant S. aureus with decreased susceptibility to linezolid and vancomycin. The wide genotypic diversity found reinforces the central role of ICU infection control in preventing nosocomial transmission.

Published
2020
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6. Key Factors Associated With Pulmonary Sequelae in the Follow-Up of Critically Ill COVID-19 Patients

Author

Jessica González, Jordi de Batlle, Iván D. Benítez, Gerard Torres, Sally Santisteve, Adriano D.S. Targa, Clara Gort-Paniello, Anna Moncusí-Moix, Maria Aguilà, Fatty Seck, Adrián Ceccato, Ricard Ferrer, Anna Motos, Jordi Riera, Laia Fernández, Rosario Menéndez, José Ángel Lorente, Oscar Peñuelas, Dario Garcia-Gasulla, Yhivian Peñasco, Pilar Ricart, Elena Abril Palomares, Luciano Aguilera, Alejandro Rodríguez, Maria Victoria Boado Varela, Belén Beteré, Juan Carlos Pozo-Laderas, Jordi Solé-Violan, Inmaculada Salvador-Adell, Mariana Andrea Novo, José Barberán, Rosario Amaya Villar, José Garnacho-Montero, José M. Gómez, Aaron Blandino Ortiz, Luis Tamayo Lomas, Alejandro Úbeda, Mercedes Catalán-González, Angel Sánchez-Miralles, Ignacio Martínez Varela, Ruth Noemí Jorge García, Nieves Franco, Víctor D. Gumucio-Sanguino, Elena Bustamante-Munguira, Luis Jorge Valdivia, Jesús Caballero, Elena Gallego, Covadonga Rodríguez, Álvaro Castellanos-Ortega, Josep Trenado, Judith Marin-Corral, Guillermo M. Albaiceta, Maria del Carmen de la Torre, Ana Loza-Vázquez, Pablo Vidal, Jose M. Añón, Cristina Carbajales Pérez, Victor Sagredo, Nieves Carbonell, Lorenzo Socias, Carme Barberà, Angel Estella, Emili Diaz, David de Gonzalo-Calvo, Antoni Torres, Ferran Barbé, María Aguilar Cabello, Victoria Alcaraz-Serrano, Cesar Aldecoa, Cynthia Alegre, Ángela Algaba Calderón, Sergio Álvarez, Antonio Álvarez Ruiz, Ruth Andrea, Maria de Alba Aparicio, Marta Arrieta, J. Ignacio Ayestarán, Joan Ramon Badia, Mariona Badía, Orville Báez Pravia, Ana Balan Mariño, Begoña Balsera, Laura Barbena, Enric Barbeta, Tommaso Bardi, Patricia Barral Segade, Marta Barroso, José Ángel Berezo García, Jesus Bermejo, Judit Bigas, Rafael Blancas, María Luisa Blasco Cortés, María Bodi Saera, Neus Bofill, María Teresa Bouza Vieiro, Leticia Bueno, Juan Bustamante-Munguira, Cecilia del Busto Martínez, David Campi Hermoso, Sandra Campos Fernández, Iosune Cano, Joan Canseco, Pablo Cardinal Fernández, Laura Carrión García, Sulamita Carvalho, Manuel Castellà, Andrea Castellví, Pedro Castro, María José Centelles-Serrano, Ramon Cicuendez Ávila, Catia Cillóniz, Luisa Clar, Cristina Climent, Jordi Codina, Pamela Conde, Sofía Contreras, Raul de Frutos Parra, Raul de Pablo Sánchez, Diego De Mendoza, Yolanda Díaz, María Digna Rivas Vilas, Cristina Dólera Moreno, Irene Dot, Pedro Enríquez Giraudo, Inés Esmorís Arijón, Teresa Farre Monjo, Javier Fernández, Carlos Ferrando, Albert Figueras, Lorena Forcelledo Espina, Enric Franquesa, Àngels Furro, Albert Gabarrus, Cristóbal Galbán, Felipe García, Beatriz García, Emilio García Prieto, Carlos García Redruello, Amaia García Sagastume, Maria Luisa Gascón Castillo, Gemma Gomà, Vanesa Gómez Casal, Silvia Gómez, Carmen Gómez Gonzalez, Federico Gordo, Maria Pilar Gracia, María José Gutierrez Fernández, Alba Herraiz, Rubén Herrán-Monge, Mercedes Ibarz, Silvia Iglesias, Maria Teresa Janer, Gabriel Jiménez, Mar Juan Díaz, Karsa Kiarostami, Juan I. Lazo Álvarez, Miguel León, Alexandre López-Gavín, Desiree Macias Guerrero, Nuria Mamolar Herrera, Rafael Mañez Mendiluce, Cecilia L. Mantellini, Gregorio Marco Naya, Iris Marco Barcos, Pilar Marcos, Enrique Marmol Peis, Marta Martín Cuadrado, María Cruz Martin Delgado, Paula Martín Vicente, María Martínez, Carmen Eulalia Martínez Fernández, Maria Dolores Martínez Juan, Basilisa Martínez Palacios, Juan Fernando Masa Jimenez, Joan Ramon Masclans, Emilio Maseda, Eva María Menor Fernández, Priscila Metora Banderas, Olga Minguez, Mar Miralbés, Josman Monclou, Juan Carlos Montejo-González, Neus Montserrat, María Mora Aznar, Dulce Morales, Sara Guadalupe Moreno Cano, David Mosquera Rodríguez, Rosana Muñoz-Bermúdez, José María Nicolás, Ramon Nogue Bou, Rafaela Nogueras Salinas, Marta Ocón, Ana Ortega, Sergio Ossa, Pablo Pagliarani, Francisco Parrilla, José Pedregosa-Díaz, Leire Pérez Bastida, Purificación Pérez, Felipe Pérez-García, Gloria Pérez Planelles, Eva Pérez Rubio, David Pestaña Laguna, Javier Prados, Andrés Pujol, Núria Ramon Coll, Gloria Renedo Sanchez-Giron, Ferran Roche-Campo, Laura Rodriguez, Felipe Rodríguez de Castro, Silvia Rodríguez, Covadonga Rodríguez Ruiz, Jorge Rubio, Alberto Rubio López, Ángela Leonor Ruiz-García, Miriam Ruiz Miralles, Pablo Ryan Murúa, Eva Saborido Paz, Ana Salazar Degracia, Miguel Sanchez, Ana Sánchez, Susana Sancho Chinesta, Bitor Santacoloma, Maria Teresa Sariñena, Marta Segura Pensado, Lidia Serra, Mireia Serra-Fortuny, Ainhoa Serrano Lázaro, Lluís Servià, Laura Soliva, Carla Speziale, Adrián Tormos, Mateu Torres, Celia Tranque-Liberal, Sandra Trefler, Javier Trujillano, Rafaela Vaca, Estela Val, Luis Valdivia Ruiz, Montserrat Vallverdú, Maria Van der Hofstadt Martin-Montalvo, Sabela Vara Adrio, Nil Vázquez, Javier Vengoechea, Clara Vilà-Vilardel, Judit Vilanova, Tatiana Villada Warrington, Hua Yang, Minlan Yang, and Ana Zapatero

Subjects
Pulmonary and Respiratory Medicine
Published
2023
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8. Remdesivir and survival outcomes in critically ill patients with COVID-19: A multicentre observational cohort study

Author

Catia Cillóniz, Anna Motos, Tatiana Castañeda, Albert Gabarrús, Ferran Barbé, Antoni Torres, Víctor D. Gumucio-Sanguino, Rafael Mañez, Jordi Solé-Violan, Felipe Rodríguez de Castro, Fernando Suarez-Sipmann, Ruth Noemí Jorge García, María Mora Aznar, Mateu Torres, María Martinez, Cynthia Alegre, Jordi Riera, Sofía Contreras, Juan Manuel Pericas, Ricard Ferrer, Jesús Caballero, Javier Trujillano, Montse Vallverdú, Miguel León, Mariona Badía, Begoña Balsera, Lluís Servià, Judit Vilanova, Silvia Rodríguez, Neus Montserrat, Silvia Iglesias, Javier Prados, Sula Carvalho, Mar Miralbés, Josman Monclou, Gabriel Jiménez, Jordi Codina, Estela Val, Pablo Pagliarani, Jorge Rubio, Dulce Morales, Andrés Pujol, Àngels Furro, Beatriz García, Gerard Torres, Javier Vengoechea, David de Gonzalo-Calvo, Jessica González, Silvia Gomez, José M. Gómez, Nieves Franco, José Barberán, Guillermo M Albaiceta, Lorena Forcelledo Espina, Emilio García Prieto, Paula Martín Vicente, Cecilia del Busto Martínez, Pablo Vidal-Cortés, José Luis García Garmendia, María Aguilar Cabello, Carmen Eulalia Martínez Fernández, Nieves Carbonell, María Luisa Blasco Cortés, Ainhoa Serrano Lázaro, Mar Juan Díaz, Aaron Blandino Ortiz, Rosario Menendez, Luis Jorge Valdivia, María Victoria Boado, Susana Sancho Chinesta, Maria del Carmen de la Torre, Ignacio Martínez Varela, María Teresa Bouza Vieiro, Inés Esmorís Arijón, David Campi Hermoso, Rafaela Nogueras Salinas, Teresa Farre Monjo, Ramon Nogue Bou, Gregorio Marco Naya, Carme Barberà, Núria Ramon Coll, Mercedes Catalán-González, Juan Carlos Montejo-González, Gloria Renedo Sanchez-Giron, Juan Bustamante-Munguira, Elena Bustamante-Munguira, Ramon Cicuendez Avila, Nuria Mamolar Herrera, Raquel Almansa, Alicia Ortega, Jesús Bermejo-Martin, Víctor Sagredo, Jose Añon, Alexander Agrifoglio, Lucia Cachafeiro, Emilio Maseda, Lorenzo Socias, Mariana Andrea Novo, Albert Figueras, Maria Teresa Janer, Laura Soliva, Marta Ocón, Luisa Clar, J Ignacio Ayestarán, Yhivian Peñasco, Sandra Campos Fernández, Mireia Serra-Fortuny, Eva Forcadell-Ferreres, Immaculada Salvador-Adell, Neus Bofill, Berta Adell-Serrano, Josep Pedregosa Díaz, Núria Casacuberta-Barberà, Luis Urrelo-Cerrón, Àngels Piñol-Tena, Ferran Roche-Campo, Amalia Martínez de la Gándara, Pablo Ryan Murúa, Covadonga Rodríguez Ruíz, Laura Carrión García, Juan I Lazo Álvarez, José Ángel Lorente, Ana Loza-Vázquez, Desire Macias Guerrero, Arturo Huerta, Daniel Tognetti, Carlos García Redruello, David Mosquera Rodríguez, Eva María Menor Fernández, Sabela Vara Adrio, Vanesa Gómez Casal, Marta Segura Pensado, María Digna Rivas Vilas, Amaia García Sagastume, Raul de Pablo Sánchez, David Pestaña Laguna, Tommaso Bardi, Rosario Amaya Villar, Carmen Gómez Gonzalez, Maria Luisa Gascón Castillo, José Garnacho-Montero, María Luisa Cantón-Bulnes, Judith Marin-Corral, Cristina Carbajales Pérez, Joan Ramon Masclans, Ana Salazar Degracia, Judit Bigas, Rosana Muñoz-Bermúdez, Clara Vilà-Vilardel, Francisco Parrilla, Irene Dot, Ana Zapatero, Yolanda Díaz, María Pilar Gracia, Purificación Pérez, Andrea Castellví, Cristina Climent, Lidia Serra, Laura Barbena, Iosune Cano, Pilar Ricart, Alba Herraiz, Pilar Marcos, Laura Rodríguez, Maria Teresa Sariñena, Ana Sánchez, Alejandro Úbeda, María Cruz Martin Delgado, Elena Gallego, Juan Fernando Masa Jimenez, Gemma Gomà, Emi Díaz, Mercedes Ibarz, Diego De Mendoza, Enric Barbeta, Victoria Alcaraz-Serrano, Joan Ramon Badia, Manuel Castella, Leticia Bueno, Adrian Ceccato, Andrea Palomeque, Laia Fernandez Barat, Pamela Conde, Javier Fernández, Albert Gabarrus, Karsa Kiarostami, Alexandre López-Gavín, Cecilia L Mantellini, Carla Speziale, Nil Vázquez, Hua Yang, Minlan Yang, Carlos Ferrando, Pedro Castro, Marta Arrieta, Jose Maria Nicolas, Rut Andrea, Marta Barroso, Raquel Pérez, Sergio Álvarez, Dario Garcia-Gasulla, Adrián Tormos, Luis Tamayo Lomas, Cesar Aldecoa, Rubén Herrán-Monge, José Ángel Berezo García, Pedro Enríquez Giraudo, Pablo Cardinal Fernández, Alberto Rubio López, Orville Báez Pravia, Juan López Messa, Leire Pérez Bastida, Antonjo Alvarez Ruiz, José Trenado, Anna Parera Pous, Cristóbal Galbán, Ana López Lago, Eva Saborido Paz, Patricia Barral Segade, Ana Balan Mariño, Manuel Valledor Mendez, Raúl de Frutos, Luciano Aguilera, Felipe Pérez-García, Esther López-Ramos, Ángela Leonor Ruiz-García, Belén Beteré, Rafael Blancas, Cristina Dólera, Gloria Perez Planelles, Enrique Marmol Peis, Maria Dolores Martinez Juan, Miriam Ruiz Miralles, Eva Perez Rubio, Maria Van der Hofstadt Martin-Montalvo, Ángel Sánchez-Miralles, Tatiana Villada Warrington, Juan Carlos Pozo-Laderas, Angel Estrella, Sara Guadalupe Moreno Cano, Federico Gordo, Basilisa Martinez Palacios, Maite Nieto, Maria Teresa Nieto, Sergio Ossa, Ana Ortega, Miguel Sanchez, and Bitor Santacoloma

Subjects
Microbiology (medical), Infectious Diseases
Published
2022

9. The Hidden Pseudomonas Pathobiome and its Clinical Implications

Author

Laia Fernandez-Barat, Rubén López-Aladid, Victoria Alcaraz-Serrano, Nil Vázquez, Leticia Bueno-Freire, Roque Pastor Ibáñez, Lena Lingren, Héctor Sanz-Fraile, Patricia Oscanoa, Rosanel Amaro, Ana Motos, Roberto Cabrera, Jordi Vila, Daniel Martínez, Jordi Otero, Ramón Farré, Niels Høiby, and Antoni Torres

Subjects
History, Polymers and Plastics, Business and International Management, Industrial and Manufacturing Engineering
Published
2022
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10. Resistance mechanisms and molecular epidemiology of Pseudomonas aeruginosa strains from patients with bronchiectasis

Author

Roberto Cabrera, Laia Fernández-Barat, Nil Vázquez, Victoria Alcaraz-Serrano, Leticia Bueno-Freire, Rosanel Amaro, Rubén López-Aladid, Patricia Oscanoa, Laura Muñoz, Jordi Vila, and Antoni Torres

Subjects
Pharmacology, Microbiology (medical), Molecular Epidemiology, Tazobactam, Respiratory diseases, Epidemiologia molecular, Microbial Sensitivity Tests, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, Ceftazidime, beta-Lactamases, Anti-Bacterial Agents, Bronchiectasis, Malalties de l'aparell respiratori, Infectious Diseases, Ciprofloxacin, Molecular epidemiology, Pseudomonas aeruginosa, Humans, Pseudomonas Infections, Pharmacology (medical), Phylogeny, Multilocus Sequence Typing
Abstract

Background Non-cystic fibrosis bronchiectasis (BE) is a chronic structural lung condition that facilitates chronic colonization by different microorganisms and courses with recurrent respiratory infections and frequent exacerbations. One of the main pathogens involved in BE is Pseudomonas aeruginosa. Objectives To determine the molecular mechanisms of resistance and the molecular epidemiology of P. aeruginosa strains isolated from patients with BE. Methods A total of 43 strains of P. aeruginosa were isolated from the sputum of BE patients. Susceptibility to the following antimicrobials was analysed: ciprofloxacin, meropenem, imipenem, amikacin, tobramycin, aztreonam, piperacillin/tazobactam, ceftazidime, ceftazidime/avibactam, ceftolozane/tazobactam, cefepime and colistin. The resistance mechanisms present in each strain were assessed by PCR, sequencing and quantitative RT–PCR. Molecular epidemiology was determined by MLST. Phylogenetic analysis was carried out using the eBURST algorithm. Results High levels of resistance to ciprofloxacin (44.19%) were found. Mutations in the gyrA, gyrB, parC and parE genes were detected in ciprofloxacin-resistant P. aeruginosa strains. The number of mutated QRDR genes was related to increased MIC. Different β-lactamases were detected: blaOXA50, blaGES-2, blaIMI-2 and blaGIM-1. The aac(3)-Ia, aac(3)-Ic, aac(6″)-Ib and ant(2″)-Ia genes were associated with aminoglycoside-resistant strains. The gene expression analysis showed overproduction of the MexAB-OprM efflux system (46.5%) over the other efflux system. The most frequently detected clones were ST619, ST676, ST532 and ST109. Conclusions Resistance to first-line antimicrobials recommended in BE guidelines could threaten the treatment of BE and the eradication of P. aeruginosa, contributing to chronic infection.

Published
2022

11. The role of efflux pump systems and OprD porine in antimicrobial resistance of Pseudomonas aeruginosa strains isolated from patients with bronchiectasis

Author

Rosanel Amaro, Laura Muñoz, Nil Vázquez, Jordi Vila, Victoria Alcaraz, Leticia Bueno, Laia Fernández-Barat, Patricia Oscanoa, Antoni Torres, Rubén López-Aladid, and Roberto Cabrera

Subjects
Antibiotic resistance, Bronchiectasis, Pseudomonas aeruginosa, business.industry, medicine, Efflux, medicine.disease_cause, medicine.disease, business, Microbiology
Published
2021
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12. Assessment of health-related quality of life in patients with bronchiectasis colonized by Pseudomonas aeruginosa

Author

Victoria Alcaraz Serrano, Patricia Oscanoa, Giulia Scioscia, Antoni Torres, Rubén López Aladid, Albert Gabarrus, Leticia Bueno Freire, Adrian Ceccato, Laia Fernandez Barat, Alexandre López Gavin, Rosanel Amaro, and Nil Vázquez

Subjects
Health related quality of life, medicine.medical_specialty, Bronchiectasis, Pseudomonas aeruginosa, business.industry, Internal medicine, medicine, In patient, medicine.disease_cause, business, medicine.disease
Published
2021
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13. Mucoid Pseudomonas aeruginosa alters sputum viscoelasticity in patients with non-cystic fibrosis bronchiectasis

Author

Beatriz Herrero-Cortina, Albert Gabarrus, Rosario Menéndez, Laia Fernández-Barat, Rosanel Amaro-Rodriguez, Antoni Torres, Nil Vázquez, Joan Llorens-Llacuna, Elena Gimeno-Santos, Jordi Puig de la Bellacasa, Victoria Alcaraz-Serrano, and Giulia Scioscia

Subjects
Adult, Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Poor prognosis, Mucociliary clearance, medicine.disease_cause, Gastroenterology, 03 medical and health sciences, fluids and secretions, 0302 clinical medicine, Internal medicine, Bronchiectasis, Mucoid Pseudomonas aeruginosa, Rheology, Sputum, Viscoelastic properties, Prevalence, medicine, Humans, Pseudomonas Infections, In patient, 030212 general & internal medicine, Aged, Glycosaminoglycans, Aged, 80 and over, Bronchiectasis, Viscosity, Pseudomonas aeruginosa, business.industry, Non cystic fibrosis bronchiectasis, Sputum, Middle Aged, Prognosis, medicine.disease, Fibrosis, Elasticity, respiratory tract diseases, Mucoid Pseudomonas aeruginosa, Cross-Sectional Studies, Phenotype, 030228 respiratory system, Mucociliary Clearance, Case-Control Studies, Mutation, Female, medicine.symptom, Rheology, business
Abstract

Introduction and aim Pseudomonas aeruginosa could acquire a mucoid phenotype due to mutations in mucA (mucoid Pseudomonas aeruginosa - mPA) that is a hallmark of poor prognosis in patients with bronchiectasis. Despite the higher prevalence of Pseudomonas aeruginosa in bronchiectasis, how mPA and non-mucoid Pseudomonas aeruginosa (non-mPA) phenotypes could affect viscoelastic properties of sputum is unknown. Our aim was to determine the relationship between Pseudomonas aeruginosa phenotypes isolation, the viscoelastic properties of sputum and the clinical outcomes in patients with bronchiectasis. Methods A cross-sectional study was conducted of sputum samples obtained by spontaneous expectoration and sent for microbiology and rheology analysis. Elasticity and viscosity were measured at two oscillatory frequencies (1 and 100 rad/s). Socio-demographic and clinical data were recorded. Results We analyzed 17 patients with mPA, 14 with non-mPA and 17 with no organism reported (NOR). Compared with the NOR group, the mPA group showed higher elasticity (median 10.30 vs. 5.70, p = 0.023), viscosity (2.40 vs. 1.50, p = 0.039), and stiffness (10.70 vs. 6.00, p = 0.024). Values in the mPA group tended to be higher compared with non-mPA. Clinically, the mPA group showed greater hospitalizations during the previous year and greater affected lobes than the non-mPA and NOR groups. Conclusions The mPA phenotype is associated with increased elasticity, viscosity and stiffness of bronchiectatic sputum. Viscoelastic properties could be used as a marker of poor mucociliary clearance in mPA, with potentially important clinical implications.

Published
2019
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14. Molecular characterization of methicillin-resistant Staphylococcus aureus clinical strains from the endotracheal tubes of patients with nosocomial pneumonia

Author

Pedro Castro, Jordi Vila, Yuly López, Antoni Torres, Anna Motos, Francisco Álvarez-Lerma, Roberto Cabrera, Rubén López-Aladid, Laia Fernández-Barat, Laura Muñoz, Nil Vázquez, and Mauro Panigada

Subjects
0301 basic medicine, Mechanism of resistance, Pneumònia, Drug resistance, medicine.disease_cause, Hospital-acquired pneumonia, chemistry.chemical_compound, Respiratory infection, Staphylococcal infections, Pharmacology (medical), Phylogeny, Biofilm, Staphylococcal Infections, Endotracheal tube, Anti-Bacterial Agents, Bacterial Typing Techniques, Intensive Care Units, Infectious Diseases, Staphylococcus aureus, Vancomycin, medicine.drug, MLST, Microbiology (medical), Methicillin-Resistant Staphylococcus aureus, Fusidic acid, Critical Illness, 030106 microbiology, Microbial Sensitivity Tests, lcsh:Infectious and parasitic diseases, Microbiology, 03 medical and health sciences, Bacterial Proteins, medicine, Intubation, Intratracheal, Humans, Ventilator-associated pneumonia, lcsh:RC109-216, business.industry, Research, Infeccions per estafilococs, Public Health, Environmental and Occupational Health, Healthcare-Associated Pneumonia, Clindamycin, Pneumonia, biochemical phenomena, metabolism, and nutrition, medicine.disease, bacterial infections and mycoses, Methicillin-resistant Staphylococcus aureus, 030104 developmental biology, chemistry, Linezolid, business, Multilocus Sequence Typing, Clonal complexes
Abstract

Background Among all cases of nosocomial pneumonia, Staphylococcus aureus is the second most prevalent pathogen (17.8%). In Europe, 29.9% of the isolates are oxacillin-resistant. The changing epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) nosocomial infections and the decreasing susceptibility to first-line antibiotics leave clinicians with few therapeutic options. The objective of our study was to determine the antimicrobial susceptibility, the associated molecular mechanisms of resistance and the epidemiological relatedness of MRSA strains isolated from the endotracheal tubes (ETT) of intubated critically ill patients in the intensive care unit (ICU) with nosocomial pneumonia caused by Staphylococcus aureus. Methods The antimicrobial susceptibility to vancomycin, linezolid, ciprofloxacin, clindamycin, erythromycin, chloramphenicol, fusidic acid, gentamicin, quinupristin-dalfopristin, rifampicin, sulfamethoxazole/trimethoprim, and tetracycline were measured. Resistance mechanisms were then analyzed by polymerase chain reaction and sequencing. Molecular epidemiology was carried out by multi-locus sequence typing. Results S. aureus isolates were resistant to ciprofloxacin, erythromycin, gentamicin, tetracycline, clindamycin, and fusidic acid. The most frequent mutations in quinolone-resistant S. aureus strains were S84L in the gyrA gene, V511A in the gyrB gene, S144P in the grlA gene, and K401R/E in the grlB gene. Strains resistant to erythromycin carried the ermC, ermA, and msrA genes; the same ermC and ermA genes were detected in strains resistant to clindamycin. The aac(6′)-aph(2″) gene was related to gentamicin resistance, while resistance to tetracycline was related to tetK (efflux pump). The fusB gene was detected in the strain resistant to fusidic acid. The most frequent sequence types were ST22, ST8, and ST217, which were distributed in four clonal complexes (CC5, CC22, CC45, and CC59). Conclusions High levels of resistance to second-line antimicrobials threatens the treatment of nosocomial respiratory infections due to methicillin-resistant S. aureus with decreased susceptibility to linezolid and vancomycin. The wide genotypic diversity found reinforces the central role of ICU infection control in preventing nosocomial transmission.

Published
2019

15. Mucoid Pseudomonas aeruginosa alter sputum viscoelastic properties in patients with non-cystic fibrosis bronchiectasis

Author

Beatriz Herrero Cortina, Elena Gimeno Santos, Antoni Torres, Victoria Alcaraz Serrano, Albert Gabarrus, Rosario Menéndez, Nil Vázquez, Laia Fernandez Barat, Joan Llorens Llacuna, Rosanel Amaro Rodriguez, and Giulia Scioscia

Subjects
Mucoid Pseudomonas aeruginosa, Pathology, medicine.medical_specialty, business.industry, Non cystic fibrosis bronchiectasis, medicine, Sputum, In patient, medicine.symptom, business
Published
2019
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16. Longitudinal examination of bronchiectasis sputum allows the early Pseudomonas aeruginosa detection

Author

Patricia Oscanoa, Rosario Menéndez, Giulia Scioscia, Rosanel Amaro, Laura Muñoz, Nil Vázquez, Elena Gonzalvo, Antoni Torres, Laia Fernández-Barat, Jorge Puig de la Bellacasa, Victoria Alcaraz, Niels Høiby, Albert Gabarrus, Lena Lingren, Adrian Ceccato, Leticia Bueno, and Daniel Godoy Martinez

Subjects
Bronchiectasis, Pseudomonas aeruginosa, business.industry, medicine, Sputum, medicine.symptom, medicine.disease_cause, business, medicine.disease, Microbiology
Published
2019
Full Text
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